Claims Policy & Procedure Specialist
- - Operations
- Minneapolis, MN, USA
- Full Time
Bind is a health technology and services company founded in 2016 and headquartered in Minneapolis, MN with satellite offices in New York and San Francisco. Bind is health insurance for the way we live now. Unlike traditional health insurance that charges you for services you may never need or want, Bind is on demand: pay for what you need, not what you don't, and adjust your coverage when those needs change. Health coverage that's flexible, clear, and intuitive.
We are creative, collaborative, and a little bit fiery. The Bind team is comprised of like-minded individuals passionate about healthcare, and our cause is the collective act of rewiring it. We embrace new ideas. We're more wheel than cog. More spark than smoke. And we are playful and venturesome in our daily mission to render real and refreshing solutions to health insurance that works better for us all.
Claims Policy & Procedure Specialist
Bind is actively seeking a highly skilled, motivated, and experienced claim policy and procedure specialist to assist the Company in setting up both a claim platform and a claims processing unit. Partner with business and technology teams to drive continuous improvement in claims operations. Focus, enthusiasm, and a dedication to excellence are all personal characteristics highly valued in the Bind organization.
- Participate in the implementation and prioritization of claim operational strategies, policies, workflow processes and standards and ensure effective utilization of them.
- Function as a liaison to Business and IT teams to align technical solutions with business needs.
- Function as a liaison to service vendors and business partners to align service delivery with strategic objectives and priorities; Assist in handling escalated service issue.
- Assess and manage operational and change readiness as it relates to new or changed process or technology solutions, new products or business models, and significant scaling/growth of the operations.
- Participate in the development and implementation of an enterprise claim platform, providing subject matter expertise on the operational components of claim processing, workflow management, and usability; align operational needs with technology requirements.
- Participate in the development of the claims organizational structure. Identify roles, resource needs, training plan and potential partnerships.
- Manage and develop staff as needed.
- Drive completion of projects and initiatives; follow through on execution of chosen strategies and demonstrate an ability to stay the course despite obstacles.
- Test benefit setup/training of staff.
- A bachelor's degree in a related field preferred.
- A minimum of five (5) years of medical claims management experience.
- Previous claims processing and customer service experience.
- Quick decision maker.
- Experience evaluating, revising and maintaining production, turnaround time.
- Experience in automating and/or re-engineering manual claim processes.
- Claim technology expertise and workflow management.
- Exceptional communication skills.
- Excellent analytical skills with ability to read and understand complex data and make thoughtful, articulate recommendations; ability to translate analysis of data into meaningful outputs.
- Excellent project management skills, with ability to manage multiple priorities with tight deadlines, and demonstrated strong problem-solving skills and attention to detail.
- Experience working as a liaison between operational departments and/or technical team.
- Proven ability to influence course of action when others are directly accountable for outcomes.
- Ability to identify key opportunities for action in an innovating environment that includes ambiguity and change.
- Experience with Agile / Scrum and other SDLC methodologies.
- Proficient in MS Visio, Word, Excel, and PowerPoint.
- Knowledge and experience in a healthcare environment with HIPAA requirements.
Bind is committed to providing equal employment opportunities. All qualified applicants and employees will be considered for employment and advancement without regard to race, color, religion, national origin, sex, disability, age, marital status, sexual orientation, veteran status, genetic information, or any other status protected by applicable law.
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